Vaginal Natural Orifice Transluminal Endoscopic Surgery Revolution: The Next Frontier in Gynecologic Minimally Invasive Surgery

Lerner, Veronica; May, Grover; Iglesia, Cheryl B.

doi:10.4293/jsls.2022.00082

Cited by 25 publications

(13 citation statements)

References 61 publications

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“…This finding could be because vNOTES-SC effectively utilized the advantages conferred by vaginal surgery, significantly shortening the operation time of vNOTES-SC through vaginal hysterectomy [ 29 ]. Moreover, the vaginal incision via vNOTES-SC is longer than the umbilical incision in LESS-SC, while the external pelvic part of the instrument in vNOTES-SC is longer than the internal pelvic part [ 30 ]. These features increase the range of motion of the instrument and relatively reduce the chopsticks effect compared with LESS-SC [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Comparative analysis of transvaginal natural orifice transluminal endoscopic surgery versus laparoendoscopic single-site sacrocolpopexy for pelvic organ prolapse: A propensity score matching study

Chen,

Zhou,

Tan

et al. 2023

Heliyon

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Section: Discussionmentioning

confidence: 99%

Comparative analysis of transvaginal natural orifice transluminal endoscopic surgery versus laparoendoscopic single-site sacrocolpopexy for pelvic organ prolapse: A propensity score matching study

Chen,

Zhou,

Tan

et al. 2023

Heliyon

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“…However, an emerging surgical technique called vNOTES, offers several advantages over cLap and vaginal approaches for treating uterine prolapse. These advantages include better exposure, scar-free cosmetic outcomes, reduced postoperative pain, lower complication rates, and faster recovery times [19].…”

Section: Discussionmentioning

confidence: 99%

High uterosacral ligament suspension by transvaginal natural orifice transluminal endoscopic surgery or laparoendoscopic surgery for uterine prolapse: a protocol for a non-inferiority randomized controlled trial

Hou,

Chen,

et al. 2023

Preprint

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Introduction: Uterine prolapse is a prevalent health condition that significantly impairs the daily activities and quality of life of women. High uterosacral ligament suspension (HULS) through conventional laparoscopy (cLap) is a frequently employed surgical procedure for treating uterine prolapse. In recent years, gynecological surgeons have increasingly considered transvaginal natural orifice transluminal endoscopic surgery (vNOTES) due to its favorable outcomes, including enhanced cosmetic appearance and expedited postoperative recovery. However, there is a lack of studies comparing the techniques of vNOTES-HULS and cLap-HULS. Therefore, this trial aims to compare the efficacy and safety of vNOTES-HULS and cLap-HULS for the treatment of uterine prolapse at stage 2 or higher, providing valuable insights for surgical decision-making. Methods A two-arm, single-center, non-inferiority randomized controlled trial (RCT) will be conducted to evaluate whether the vNOTES-HULS procedure is non-inferior to the cLap-HULS procedure in the repair of uterine prolapse. The study aims to recruit a total of 116 patients diagnosed with stage 2 or above uterine prolapse from Meizhou People's Hospital. These patients will be randomly allocated to either the vNOTES-HULS or cLap-HULS intervention. The primary objective of the study is to determine the rate of successful uterine prolapse treatment during the 1-year follow-up evaluation. Secondary outcomes include perioperative parameters, complications, costs, postoperative recovery, and quality of life assessed at 1-month, 1-year, and 5-year intervals. Discussion This study aims to compare the effectiveness of vNOTES-HULS and cLap-HULS in the treatment of stage II or higher uterine prolapse based on the Pelvic Organ Prolapse Quantification classification. Trial registration: The study protocol received approval from the Research Ethics Committee of the Meizhou People’s Hospital (No. 2022-C-23) on October 3, 2022. It was registered into the Chinese Clinical Trials Registry on September 6, 2022 (no. ChiCTR2200063408). This study is currently in progress.

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“…Preparation, setup, and instrumentation were described in a 2022 article. 1 It is beyond the scope of this review to cover the vaginal portion of this procedure for novice surgeons. Numerous resources (textbooks, articles, surgical videos) are available on this topic if more indepth understanding is desired.…”

Section: Vnotes Hysterectomy Surgical Techniquementioning

confidence: 99%

“…However, multiple barriers prevented widespread use of the vaginal route. 1 , 2 The history of the vaginal natural orifice transluminal endoscopic surgery (vNOTES) evolution is tied closely to transabdominal laparoendoscopic single-site surgery (LESS), 3 which emerged as an alternative to popular multiport laparoscopy and robotics. However, the challenges of transabdominal LESS halted its widespread adoption, 4 and vNOTES emerged in the last decade as a way to revive vaginal surgery, which has been declining at a rapid rate, while laparoscopy and robotics gained acceptance.…”

Section: Introductionmentioning

confidence: 99%

Vaginal Natural Orifice Transluminal Endoscopic Surgery Hysterectomy Deconstructed: Expanding Minimally Invasive Gynecologic Surgeons' Toolbox

Lerner,

Stuart,

Baekalandt

2024

Journal of Gynecologic Surgery

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Background: The introduction of vaginal natural orifice transluminal endoscopic surgery (vNOTES) to the toolbox of gynecologic surgeons has the potential to reverse the trend of vaginal hysterectomy declines. Methods: This review discusses nuances of the vNOTES technique applied to hysterectomy; describes vNOTES hysterectomy, step-by-step (including tips and tricks for low- and high-complexity cases for surgeons who may want to incorporate vNOTES hysterectomy into their surgical repertoires); and examines evidence and research trends in this field. Results: The descriptions in the text, figures, tables, and videos all contribute to giving readers a clear understanding of vNOTES, its advantages, limitations, and research potentials. Conclusions: vNOTES hysterectomy is a unique blend of vaginal, laparoscopic, and laparoendoscopic single-site surgery (LESS) techniques and is not a new procedure, but rather another tool to use in minimally invasive gynecologic surgery. (J GYNECOL SURG 40:78)

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Vaginal Natural Orifice Transluminal Endoscopic Surgery Revolution: The Next Frontier in Gynecologic Minimally Invasive Surgery

Cited by 25 publications

References 61 publications

Comparative analysis of transvaginal natural orifice transluminal endoscopic surgery versus laparoendoscopic single-site sacrocolpopexy for pelvic organ prolapse: A propensity score matching study

Comparative analysis of transvaginal natural orifice transluminal endoscopic surgery versus laparoendoscopic single-site sacrocolpopexy for pelvic organ prolapse: A propensity score matching study

High uterosacral ligament suspension by transvaginal natural orifice transluminal endoscopic surgery or laparoendoscopic surgery for uterine prolapse: a protocol for a non-inferiority randomized controlled trial

Vaginal Natural Orifice Transluminal Endoscopic Surgery Hysterectomy Deconstructed: Expanding Minimally Invasive Gynecologic Surgeons' Toolbox

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